What risks are associated with contamination at the time of CVC insertion?

Contamination at the time of central venous catheter (CVC) insertion poses significant risks, with systemic infection being one of the most critical. When the catheter is inserted, if the insertion site or the catheter itself is contaminated with bacteria or other pathogens, these microorganisms can gain direct access to the bloodstream. This breach in the sterile barrier can lead to bloodstream infections, which may develop into severe systemic infections, such as sepsis. Given that CVCs are often used in vulnerable populations, such as those in nursing homes, the implications of a systemic infection can be particularly severe, leading to increased morbidity and mortality.

In contrast, while device malfunction and localized tissue damage can occur as a result of improper insertion techniques or device issues, they are less directly related to the microbial contamination aspect. Allergic reactions can occur due to materials in the catheter or medications administered but are not directly linked to contamination at the time of insertion. Thus, systemic infection is the most pertinent and serious risk associated with CVC insertion contamination.